allows increase Medicaid Direct rates from the pre-COVID rate level for Private Duty Nursing service providers, enrolled in the Medicaid or NC Health Choice program. The new rate will be $11.25 per 15-minute unit.

annual update to DMEPOS in order to align with Medicare changes.

revises the quarterly nursing home supplemental payment, also known as MQIP, for dates of service in the quarter ending March 31, 2022.

modifies inpatient and outpatient reimbursement rates, including for critical care supplements, wage area adjustment indices for border status hospitals, cost-to-charge ratios, and outpatient access payments.

increases the percentage used to calculate rates for Certified Registered Nurse Anesthetists (CRNA) Services to 100% of North Carolinas’ Medicaid Physician Fee Schedule.

revises nursing facility 2022 rate year reimbursement methods to establish new rate add-ons, amend existing rate add-ons, and further update certain COVID-19 related payments. The proposed amendment also includes reimbursement methodology to distribute state legislative appropriation in the amount of $25 million for workforce retention and recruitment initiatives.

authority for consolidating the Disproportionate Share Hospital (DSH) process into two steps.

amends the provisions governing outpatient hospital services in order to provide reimbursement for laboratory testing for Coronavirus Disease 2019 (COVID-19) separately from outpatient hospital surgery fee schedule payments.

1)Incorporates federal HCPCS updates to Medical Clinic and Ambulatory Surgical Center fee schedules to remain compliant with
HIPAA; 2. Adds payment for specified drugs on Family Planning Clinic fee schedule; 3. As federally required by approved state
plan, updates physician-administered drug rates on Dialysis Clinic, Behavioral Health Clinic, and Medical Clinic fee schedules.

This amendment updates the description of the Medicaid Recovery Audit Contractor program.